title: Short-term prognosis of living-donor kidney transplantation from hypertensive donors with high-normal albuminuria.
abstract: BACKGROUND
  High-normal albuminuria (HNA) is an independent predictor of cardiovascular risk in the general population. Although hypertensive donor (HTD) candidates with HNA were considered acceptable donors by the Amsterdam Forum 2004, the transplant prognosis of HTDs with HNA has not been determined. Therefore, we investigated the transplant prognosis of HTDs with HNA.
  
  
  METHODS
  We retrospectively analyzed 52 adult living-donor kidney transplants performed at Kagawa University Hospital. HNA was defined as albuminuria of 15 to 30 mg/g Cr. Changes in kidney function of donors and recipients were assessed up to 2 years after transplantation.
  
  
  RESULTS
  Overall, 38 donors were normotensive and 14 were hypertensive. Nine of 14 HTDs exhibited HNA before donation. More HTDs with HNA had arteriosclerotic vasculopathy or glomerulosclerosis than did normotensive donors (NTDs). Hypertension and the degree of albuminuria did not affect the donors' posttransplantation kidney function. The risk of discompensatory changes in kidney function after donation was significantly higher in HTDs with HNA than in NTDs (odds ratio, 10.5; 95% confidence interval, 1.51-72.9; P=0.02). In multivariate analysis, the coexistence of hypertension and HNA was not significantly associated with discompensatory changes after donation (adjusted odds ratio, 6.04; 95% confidence interval, 0.19-192; P=0.31). Recipients of HTDs with HNA had similar allograft survival rates but lower allograft function compared with recipients of NTDs.
  
  
  CONCLUSIONS
  Although further studies are needed to confirm our results, the short-term prognosis of living-donor kidney transplantation was similar between HTDs with HNA and NTDs.
authors.affiliation: 1 Division of Nephrology and Dialysis, Department of CardioRenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan. 2 Department of Urology, Tokyo Women's Medical University, Tokyo, Japan. 3 Department of Pathology, Kagawa University, Kagawa, Japan. 4 Department of Urology, Kagawa University, Kagawa, Japan. 5 Department of Pharmacology, Kagawa University, Kagawa, Japan. 6 Address correspondence to: Tadashi Sofue, M.D., Ph.D., Division of Nephrology and Dialysis, Department of CardioRenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-Cho, Kita-Gun, Kagawa 761-0793, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Sofue
authors.forename: Masashi
authors.initials: M
authors.lastname: Inui
authors.forename: Taiga
authors.initials: T
authors.lastname: Hara
authors.forename: Kumiko
authors.initials: K
authors.lastname: Moriwaki
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kushida
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kakehi
authors.forename: Akira
authors.initials: A
authors.lastname: Nishiyama
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kohno
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D001794:Blood Pressure; D046148:Donor Selection; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D007564:Japan; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome